Quality Improvement Commons^™

Improving Accurate Documentation Of Appearance Within The Mse Based On Bmi, Shaina Aifuwa, Sampreeth Murali, Valerie Cordero, Nadia Jacob, Cristobal Cintron, Almari Ginory, Sarah Fayad

North Florida Division GME Research Day 2023

No abstract provided.

Management Of Blood Pressure In Pregnancy: New Perspectives From The Chap Trial, Virginia Lowe, Gabriella Nonni, Kerry Holliman

Central & West Texas GME Research Day 2023

No abstract provided.

Descriptive Assessment Of The Pediatric Emergency Team System: The Memorial Health University Medical Center Experience, Ashley Cheek, Lauren Hebert, Sunil Keshwah, Jessica Lee

South Atlantic Division GME Research Day 2023

No abstract provided.

Improving Spiritual Care Competency Among Intensive Care Unit Nurses: Promoting Holistic Patient Care Towards End-Of-Life, Joanne Nguyen, Dana Bagis

Nursing | Student Research Posters

Intensive care unit (ICU) nurses play a crucial role in providing physiological stabilizing care in a dynamic and fast-paced environment, often marked by constant changes and variability in complex patients. Despite their specialization, the aspect of spiritual care tends to be overlooked, particularly in the context of end-of-life care. This is significant because previous studies have shown that a lack of spiritual care leads to poorer health outcomes, decreased coping, increased depression, and diminished quality of life for patients. This research proposal aims to investigate the spiritual care competency among ICU nurses who partake in spiritual care based training, with …

Implementation Levels Of Electronic Health Records And Their Influence On Quality And Safety, Soumya Upadhyay

Healthcare Administration and Policy Faculty Research

Improvement in quality and patient safety outcomes have been at the forefront of the United States healthcare system. Policies advocate for implementing different electronic health records (EHR) levels to support this effort. Several studies have demonstrated mixed results on the impact of EHR on quality and safety outcomes. Our study delves deeper into gaining an understanding of this influence on hospitals that have adopted various levels of EHR, especially intermediate and comprehensive. Using a longitudinal study design for general acute care hospitals within the U.S., we examine the relationship between intermediate and comprehensive EHR on quality (readmission rates for pneumonia …

Assessing The Patient Experience Evaluation Methodology: A Review Of The Hcahps Survey And Related Processes, Michael Molta

Full-Text Theses & Dissertations

The healthcare industry has undergone substantial changes that influence how hospitals evaluate success. Legislation from the Centers for Medicare and Medicaid Services (CMS.gov, 2023) that informs reimbursement levels of patient populations in all U.S. hospitals require organizations to focus on patient experiences, more specifically on scores from the Hospital Consumer Assessment of Healthcare Providers and Systems Survey, referred to as HCAHPS (pronounced H-caps). The Consumer Assessment of Healthcare Providers and Systems Survey or CAHPS® Hospital Survey or Hospital CAHPS® (CAHPS ® is a registered trademark of the Agency for Healthcare Research and Quality). This standardized survey instrument and data collection …

The Relative Contribution Of Health-Care Points Of Service To Overall Patient Satisfaction At A University Health Center, Jay M. Parikh

Honors Undergraduate Theses

Throughout the process of receiving healthcare, a patient is affected by several factors and processes. To just name a few, how long a patient must wait at the clinic, how friendly the front desk is, how the nurse treats the patient, how effective the physician is with his or her communication, what the cost of a patient's healthcare is, and how clean the clinic is all affect the patient's experience. When clinics excel in these factors, it promotes a favorable relationship between the patient and the clinic. Patients trust the healthcare provider and desire to continue attending that clinic when …

Clustering Hospital Performance Using Group-Based Multi-Trajectory Modeling With Singular Bayesian Information Criterion, Gaixin Du

Theses and Dissertations--Epidemiology and Biostatistics

Hospital performance is complex and patient-experience oriented. Currently, the Centers for Medicare and Medicaid Services (CMS) evaluate hospitals yearly with a single score of one to five ("Star Rating") using composite measures from five domains. However, a single composite score cannot fully describe it, and alternative measures should be considered. Healthcare quality improvement needs long-term data to validate effectiveness. Group-based multi-trajectory modeling (GBMTM) estimates probabilities of latent group membership based on longitudinal profiles from multiple outcomes. We use GBMTM to identify groups of hospitals with similar performance in SAS PROC TRAJ.

We downloaded Medicare-eligible hospitals (N=5,111) that provided patient care …

Management Of Opioid Use Disorder In Primary Care, Carolyn Jeffries

Capstone Showcase

The prevalence of opioid use disorder (OUD) in the United States, and worldwide, has drastically increased in the span of 2-3 years. OUD is considered chronic condition and as such requires routine care over a lifetime. This makes OUD patients excellent candidates to be managed by primary care providers (PCPs). This article discusses the various barriers to treatment of OUD in a primary care setting as well methods and models that aim to mitigate these barriers. We will also review how to take a detailed assessment of an OUD patient, mainstays of medication assisted treatment (MAT), and management of side …

Coh 1700: Health Care Coordination Syllabus, Sasha Harry

Open Educational Resources

This is the syllabus for a Health Care Coordination course.

The goal of health care coordination is to improve patient outcomes with better health care services. Care coordinators play a critical role in improving patient care. Students will learn how to effectively advocate for patients and interact with members of the healthcare team in finding solutions to provide high quality, value-based, and efficient care. Effective communication styles, assessing patient’s needs and goals, and helping with patients’ transitions of care are among many topics covered in this course. Upon course completion, students will have acquired basic knowledge and skills to educate, …

Improving Provider Retention Through Addressing Burnout At A Federally Qualified Health Center: A Quality Improvement Initiative, Emily Grattan

DNP Scholarly Projects

Background: Primary care providers employed by federally qualified health centers (FQHC) working with underserved populations experience high levels of burnout as patients are often medically complex, face healthcare disparities and societal stigmas. The aim of the project was to alleviate burnout and improve provider retention through introduction of organizational support measures. Participants involved were healthcare providers, as well as nurse management and senior leadership.

Methods: The quality improvement approach for this project utilized the Plan-Do-Study-Act (PDSA) cycle and a driver diagram to guide the selected interventions. Interventions were based on categories from Mayo’s Clinic’s Nine Organizational Strategies to Promote Engagement …

Improving Patient Access To Gastroenterology Through A Nurse-Practitioner-Led Clinic: A Quality Improvement Project, Kayla Northam

DNP Scholarly Projects

The United States has a critical healthcare access issue for gastroenterology patients. Delays in treatment can lead to expensive complications, including emergency room visits, hospitalization, and surgery. Creating a rapid-access clinic (RAC) for gastroenterology so that patients can obtain a quick and efficient evaluation of their symptoms in a shorter appointment time can help decrease the delay in care and generate more revenue for the hospital. Over 8 weeks in 2023, Dartmouth Hitchcock Medical Center Department of Gastroenterology used a telemedicine-only RAC to see patients for 20 minutes rather than the traditional 60-minute period. As a result, the RAC saw …

Patient Characteristics And Telehealth Visits In A Hepatology Clinic, Maria E. Walters

DNP Projects

BACKGROUND: In an attempt to decrease significant no-show rates amongst telehealth patients in a Hepatology outpatient clinic, a clinic-specific intervention was executed, which was efficient in decreasing no-show rates, however could not continue to be financially supported.

PURPOSE: The purpose of this study was to evaluate correlations between demographic data and social determinants of health with patients who showed and did not show for their telehealth appointments, with an overall goal of determining if there is a need for targeted support for telehealth appointments to decrease no-show rates.

METHODS: Electronic health records of telehealth patients were reviewed in an …

Electronic Cigarettes And Young Adults: Use Of Screening Tools And Provider Knowledge, Kayla Erin Chelf

DNP Projects

Background: Electronic Cigarette (e-cigarette) use is now more common than traditional cigarette use in adolescents and young adults (Dinardo & Rome, 2019). There is concern that the lack of screening for use and knowledge about the health consequences of e-cigarette use is driving this growth.

Objective: The purposes of this project were to (1) assess baseline e-cigarette knowledge and screening practices from healthcare professionals, and (2) evaluate changes in knowledge after delivery of an educational intervention about e-cigarettes.

Methods: In this quasi-experimental study a seven-question survey on screening practice and knowledge concerning e-cigarettes in young adults was posted on the …

Evaluation Of A Discharge Clinic Implemented For Patients Without A Primary Care Provider Or Access To Their Primary Care Provider, Jessica Sass

DNP Projects

Background: Patients transitioning from an inpatient hospital stay to self-care responsibilities post-discharge are at risk for readmission resulting in increased cost and resource utilization. Care transition programs can result in cost avoidance and decreased resource utilization.

Purpose: The purposes of this project were to: (a) determine if implementation of a Discharge Clinic affected 30-day readmission rates in patients without a primary care provider, (b) ascertain if a visit by a paramedicine program paramedic impacted 30-day readmission rates in patients who missed their Discharge Clinic appointment, and (c) find out whether a second post-discharge phone call influenced 30-day readmission rates.

Method: …

Modified Early Warning Scoring (Mews) Versus Epic Deterioration Index (Edi): Battle Royale For Which Has The Best Patient Outcomes In The Inpatient Setting, Dirk A. Church

DNP Projects

Abstract

Background: The increased workload bedside nurses face today requires new tools to assist with the identification of deteriorating patients during hospitalization. The Modified Early Warning Score (MEWS) tool has formed the background of early warning tools. Newer, more complex tools, like Epic’s Deterioration Index (EDI), have been developed to identify patient deterioration earlier. There is lack of evidence in the literature comparing different early warning tools, implementation, and patient outcomes.

Objective: The purpose of the study was to examine models for EWS notification for RRT and patient outcomes between the use of the MEWS and EDI in an adult, …

Dead End: Challenges In Healthcare Delivery To Older Adults With History Of Dementia And Incarceration- A Case Report, Shruti Anand, Saket Saxena

Journal of Geriatric Emergency Medicine

No abstract provided.

Assessing The Relationships Between Direct And Vicarious Exposure To Healthcare Discrimination And Erasure, Mistrust In Healthcare, And The Healthcare Utilization Behaviors Among Transgender And Gender Independent Individuals, Kyle L. Mason

Theses and Dissertations

Healthcare inaccessibility through direct exposure (i.e., personal) to myriad forms of gender identity-related discrimination and erasure among the Transgender and Gender Independent (TGI) population has been documented by prior studies. The myriad barriers that individuals who embody TGI identities encounter to accessing healthcare are associated with the underutilization of healthcare, which may further exacerbate the health disparities that exist between this population and cisgender individuals in the United States (U.S.). Although the impacts of the harm that direct exposure to healthcare discrimination and erasure may have on TGI individuals are known, their exposure to such harm vicariously (i.e., through observation …

Multimethod Process Evaluation Of A Community Paramedic Delivered Care Transitions Intervention For Older Emergency Department Patients, Gwen Costa Jacobsohn, Apoorva P Maru, Rebecca K Green, Angela N Gifford, Matthew D Lukasik, Tikiri Bandara, Thomas V Caprio, Amy L Cochran, Jeremy T Cushman, Courtney M C Jones, Amy J H Kind, Michael Lohmeier, Manish N Shah

Faculty, Staff and Student Publications

OBJECTIVE: We assessed fidelity of delivery and participant engagement in the implementation of a community paramedic coach-led Care Transitions Intervention (CTI) program adapted for use following emergency department (ED) visits.

METHODS: The adapted CTI for ED-to-home transitions was implemented at three university-affiliated hospitals in two cities from 2016 to 2019. Participants were aged ≥60 years old and discharged from the ED within 24 hours of arrival. In the current analysis, participants had to have received the CTI. Community paramedic coaches collected data on program delivery and participant characteristics at each transition contact via inventories and assessments. Participants provided commentary on …

Healthcare Utilization Among Infants Discharged From The Neonatal Intensive Care Unit: A Descriptive Cost Analysis, Nutan B Hebballi, Elenir Bc Avritscher, Elisa Garcia, Andrew Bain, Marisa A Bartz-Kurycki, Kuojen Tsao, Mary T Austin

Faculty, Staff and Student Publications

The cost of readmissions of neonatal intensive care unit (NICU) graduates within 6 months and a year of their life is well-studied. However, the cost of readmissions within 90 days of NICU discharge is unknown. This study's objective was to estimate the overall and mean cost of healthcare use for unplanned hospital visits of NICU graduates within 90 days of discharge A retrospective review of all infants discharged between 1/1/2017 and 03/31/2017 from a large hospital system NICUs was conducted. All unplanned hospital visits (readmissions or stand-alone emergency department (ED) visits) occurring within 90 days post NICU discharge were included. …